Just a fantasy, or something I should persue?

Examine49 · Jun 24, 2015

I say: pursue! Good Luck.

BR157 · Jun 29, 2015

I did volunteer EMS/rescue/fire (EMT-B IV cert) for about 7 years while trying to find a job in my college field (ecology). When I was younger in my teens I never considered ems/health care at all as it wasn't on the table but when I got a taste of it, I loved the huge calls and the saves and knowing I WAS MAKING A DIFFERENCE. I tried getting onto paid depts but the rough hiring + nepotism was insane, so I gave up fire fighting but still liked the medical/rescue..

Saves? Yes, you may have gotten a few people to the hospital but you will find that EMS is just the first step in "saves" and just having a heart beat is not always a "save". In the ICU you would see just how much effort goes into saving someones's life and often the end result might be a save but not the one you read about in the newspaper where the patient gives the EMT a hug later.

So my question is, given that the EMS was really cool and exciting, minus the routine calls of passed out diabetics etc helicopter evac/EMS seems like the ultimate in prehospital care and excitement. I am under no delusion I would have to go back to school to get my RN, and then work ER/ICU for a few years but is ICU at all like the excitement of prehospital? I did a few shifts in the ER for my IV cert and I was amazed at how boring it was, just a bunch of old people needing cleaning, maybe it was a bad rotation but it scared me from the ER.
My new job is decent, but I can't help but feel like I am missing something and my mind has seized upon this from my past, any help here? Thanks tons, I can answer any questions.

Too bad you don't think a passed out diabetic is not exciting enough for you. Do you realize just how serious that can be if not treated or the proper on going treatment is not sort?

Just a bunch of old people needing cleaning? I don't think you really have embraced the real medical side. It involves a lot of less glamorous stuff to provide real care to patients of all ages. "Old people" need care also and sometimes even the younger ones need more than just a cool rescue.

ICU at all like the excitement of prehospital? In ICU you grow up and not take on the real cool call mentality because you will see just how much work goes into actually saving a life. You will also quickly grow up when you see just how life changing that cool call was for a patient and their family. While in the ICU you may be part of the team who tells the patient their life as they knew it will permanently be over and they still may have months or years of hospital stays and rehab. You might even have to clean up a 22 y/o who had been very athletic until they broke their neck on a mountain hike. As a nurse you would have to help them with all of their bodily functions and teach them or their family members to wipe their butt. That might sound blunt but until you actually know someone who has had a devastating injury and how much pride they have to swallow to ask family to care for them, you may not know the full impact of what a cool save really is.

You will also be way too busy in the ICU managing multiple drips and getting the patients to all the procedures to think about being bored. You may find yourself hoping to someday know what bored actually is with a couple of very stable patients to care for.

If your flight friend was really honest with you she would have told you about the large number of patients transported by the helicopter which could easily gone by ALS or even BLS ground from the scene. Sometimes it is just because the first responding EMTs and Paramedics were too lazy to drive 20 minutes to the hospital. Other times it will because the doctor just wants the patient flown from a hospital rather than driving even though the distance is short.

You have only seen a small snippet of the medical world. It sounds like you just want the cool calls. Maybe for awhile, at least while you take a year or two of prerequisites to get into a good nursing program or the first two years of the BSN, you need to continue volunteering on an ambulance. You didn't mention working for a paid ambulance service but I suspect you may not like the boring transport calls. No one has probably told you that every patient gives you a chance to learn something including the boring old ones.

I might sound critical but you sound like a very naÃ¯ve EMT who already has a very skewed view of saves, cool stuff and BS calls. Don't be that guy wearing the whacker t-shirts when considering this career change.

windsurfer8, BSN, RN · Jul 7, 2015

I agree with BR157

If you are content with the excitement of your current job then stick with it. No the ICU is not non stop excitement. It is intense and demanding work that is VERY serious. You sound like the want just the excitement and drama without the "boring" part (I don't understand that part).

If you want thrills and excitement you are better off sticking with your current job. You don't just hang out in an ICU for 3 years then become a flight nurse. You have to be a PREMIER ICU nurse...You have to prove yourself over and over. The patient needs a top notch nurse. They are not there so you get a proper thrill at work.

klallen · Jul 11, 2015

Sometimes it is just because the first responding EMTs and Paramedics were too lazy to drive 20 minutes to the hospital.

I have a feeling you have never work as or with EMTS/Medics but a helicopter is not called just because they are too "lazy" to transport a patient. 20 minutes is a long transport time for a critically ill patient. Working in an ICU I would think you would know most critically ill patients don't have 20 minutes and need a hospital sooner than later.

Also nurses and doctors and everyone in the hospital all work very hard to treat their patients but please don't knock pre-hospital care. yes most "saves" happen in the hospital but alot of times they are possible because of the EMTS/Medics and yes sometimes Medics/EMT's have "saves themselves and they work just as hard as ICU nurses do.

At the end of the day people are alive because both pre-hospital and hospital care.

BR157 · Jul 13, 2015

I have a feeling you have never work as or with EMTS/Medics but a helicopter is not called just because they are too "lazy" to transport a patient. 20 minutes is a long transport time for a critically ill patient. Working in an ICU I would think you would know most critically ill patients don't have 20 minutes and need a hospital sooner than later.
Also nurses and doctors and everyone in the hospital all work very hard to treat their patients but please don't knock pre-hospital care. yes most "saves" happen in the hospital but alot of times they are possible because of the EMTS/Medics and yes sometimes Medics/EMT's have "saves themselves and they work just as hard as ICU nurses do.
At the end of the day people are alive because both pre-hospital and hospital care.

I find your comments to be very naÃ¯ve. Since you are a CNA working in the ICU only maybe you have never been in the ER where the patient transported by a helicopter was released before the helicopter could get back to base.

Attitudes like yours are what keep some air ambulance companies flying and sometimes very unsafely. They want everyone like you to believe every call for a helicopter is a life threatening situation. This puts not only the patient but also the crew members at great risk when inappropriate flights are taken.

Maybe you aren't aware of the risks a flight team takes every time they are dispatched or the problems with over utilization of a medical helicopter. Not one thing I stated is out of line with what has been stated before by others and many with MD behind their name as well as numerous state and Federal investigators.

I have to ask, how long do you think a patient should lay around at scene waiting for a helicopter if the hospital is only 20 minutes by ground? It may take 5 - 10 minutes for a ground EMS crew to decide the patient needs to fly and another 2 - 5 minutes to dispatch the helicopter depending on protocols. It will take maybe 5 - 10 minutes to get the crew in the helicopter and to get the flight started. It may take another 15 minutes to fly to the scene. It will take several minutes to get a report and the patient packaged into the helicopter. The flight may then take another 15 to flight back to the hospital. How much time beyond a 20 minute ambulance ride does that add up to? You are actually knocking prehospital Paramedics by believing they are not capable of taking care of a critically ill or injured patient for 20 minutes in an ambulance.

You would have to be totally removed from any aspect of EMS to not have heard about these issues in HEMS.

Reduce Inappropriate Helicopter Utilization in EMS - Journal of Emergency Medical Services

Be sure to look at the references used in this article.

Although HEMS has become an important
component of EMS, it's often overused. Most HEMS operators have a "you
call, we haul" policy. Few HEMS programs have the desire to limit any
flights because increased flight numbers equal increased revenue. Over
the past several years, the HEMS industry has slowly transitioned from
hospital-based, non-profit services to community-based, for-profit
operations. Thus, there's no incentive for most HEMS operators to
decrease flights. In fact, there's an obvious financial incentive to
increase flight volume.â€ž

Transport Times
HEMS transport is more rapid than GEMS
transport. Despite this, at distances shorter than 45 miles or ground
transport times less than 30â€“45 minutes, ground transport is typically
faster. In a California study, researchers found GEMS to always be
faster at distances shorter than 10 miles. HEMS was found to be faster
if simultaneously dispatched with GEMS (which rarely happens). If HEMS
wasn't dispatched simultaneously with GEMS (the more common scenario),
GEMS was faster at distances shorter than 45 miles.â€ž

The

klallen · Jul 15, 2015

I find your comments to be very naÃ¯ve. Since you are a CNA working in the ICU only maybe you have never been in the ER where the patient transported by a helicopter was released before the helicopter could get back to base.

I actually have not only worked in ICU I have spend a good amount of time working in a level 1 trauma ER at a nationally ranked hospital with a prestigious Flight program for my paramedic program and I have never seen or heard of a patient that was air lifted in to get discharged that quickly.

Attitudes like yours are what keep some air ambulance companies flying and sometimes very unsafely. They want everyone like you to believe every call for a helicopter is a life threatening situation. This puts not only the patient but also the crew members at great risk when inappropriate flights are taken.
Maybe you aren't aware of the risks a flight team takes every time they are dispatched or the problems with over utilization of a medical helicopter. Not one thing I stated is out of line with what has been stated before by others and many with MD behind their name as well as numerous state and Federal investigators.

It is not "people like me" that keep air ambulance companies flying unsafely. I cant speak for the companies you seem to have so much knowledge about, but I can speak fr the one at my hospital. They take their safety VERY seriously and if it is unsafe they DO NOT FLY. In the 30 years of service there has only been one fatal accident and it was and is not taken lightly. Also I fully understand that not every call is not life threatening. Most of the call done at our hospital are transports. But they aren't done because EMT's and Medics are lazy like you seem to believe. A lot of the patients are too sick for the hospitals in the UP and need to be transported down to us. I am not knocking pr hospital medics but at the end of the day they are only cleared to do so much. At least here in Michigan there are things flight nurses can do for the patient medics aren't allowed or equipped to do. Also sometimes it takes the fire fighters at least 20 minutes just to be able to get the patient out so in the time you can have the chopper getting ready and arriving. When you have already lost time in extrication adding on another 20 minutes by ground when you have the chopper there and ready? doesn't make since not to use it. It all depends on the scene the patient and a ton of other factors. If you use the resource correctly it can save a patient. To say medics/EMT's used air ambulances because they are lazy is wrong.

I'm curious have you ever worked as a EMT/ Medic? how about as a flight nurse or for a air ambulance company? It sounds like you have done your research but I'm curious if you have ever been in that situation where you have to make a call if the patient goes by ground and air. I'm sure its not always black and white or one that is taken lightly.

canigraduate · Jul 15, 2015

You kind of sound like an adrenaline junkie. Maybe you could look into aerial firefighting. Those people are crazy dedicated and, well, crazy.

I talked with a flight nurse in Michigan. She loved it. However, she said that it was long stretches of boredom when flying conditions were poor. She also said that it was a very competitive field and she wasn't able to get in until she had eight years of mixed ER and ICU experience. She also said that the company she worked for normally hired people with at least a decade of critical care experience and preferred trauma certified ICU nurses, so she was surprised when she got the job.

I would ask around and see if you could hang out with a crew while they were grounded. They would be able to tell you plenty and you could make a more informed decision.

CraigB-RN, MSN, RN · Jul 15, 2015

I think if many of us were being honest, we'd admit that we had fantasies about what we wanted to be when we grew up. Prior to becoming a medic, I wanted to be Roy and Johnny. Then as I learned more, I found I'd rather be Dixie. Of course I don't have her legs.

ICU can be exciting, but Critical Care medicine is as much about the minute details as it is about the big things. I've gone for days in the ED without seeing anything "exciting" but then other days I long for some peace and quite.

A pipe dream maybe, but any dream is worth pursuing. Along the path though, as you learn more and are exposed to more things, you may find that your dream isn't what you really want. On of my medic friends was sure he was going to be a Trauma Nurse, but when he did his clinical he found that he really like pediatrics.

So continue your education, do you research and keep an open mind as you learn.

BR157 · Jul 16, 2015

I actually have not only worked in ICU I have spend a good amount of time working in a level 1 trauma ER at a nationally ranked hospital with a prestigious Flight program for my paramedic program and I have never seen or heard of a patient that was air lifted in to get discharged that quickly.
It is not "people like me" that keep air ambulance companies flying unsafely. I cant speak for the companies you seem to have so much knowledge about, but I can speak fr the one at my hospital. They take their safety VERY seriously and if it is unsafe they DO NOT FLY. In the 30 years of service there has only been one fatal accident and it was and is not taken lightly. Also I fully understand that not every call is not life threatening. Most of the call done at our hospital are transports. But they aren't done because EMT's and Medics are lazy like you seem to believe. A lot of the patients are too sick for the hospitals in the UP and need to be transported down to us. I am not knocking pr hospital medics but at the end of the day they are only cleared to do so much. At least here in Michigan there are things flight nurses can do for the patient medics aren't allowed or equipped to do. Also sometimes it takes the fire fighters at least 20 minutes just to be able to get the patient out so in the time you can have the chopper getting ready and arriving. When you have already lost time in extrication adding on another 20 minutes by ground when you have the chopper there and ready? doesn't make since not to use it. It all depends on the scene the patient and a ton of other factors. If you use the resource correctly it can save a patient. To say medics/EMT's used air ambulances because they are lazy is wrong.
I'm curious have you ever worked as a EMT/ Medic? how about as a flight nurse or for a air ambulance company? It sounds like you have done your research but I'm curious if you have ever been in that situation where you have to make a call if the patient goes by ground and air. I'm sure its not always black and white or one that is taken lightly.

Did you know there are also Flight Paramedics? Do you know the protocols of all Paramedics in the US? You are basing all of your comments on one helicopter and one you don't work on as a crew member.

I pointed out what is happening in flight programs and what has been done and still needs to be done to curb overuse of HEMS.

Every one active in EMS has known someone who has called a helicopter to keep from driving a few more miles.

If your helicopters are being used on calls just a few minutes away then I would say your system is part of or a victim of the situation I described.

You, as CNA and EMT, are defending your ideal world which I hate to say has many flaws. Hiding your head in the sand and defending the issues of overuse is not keeping SAFETY in mind. Finish your Paramedic and get some experience on an ambulance before making anymore blanket statements. At the very least, read more about HEMS to learn of the issues of overuse.

Some of these issues should be questioned by anyone seeking a career with a flight team.

klallen · Jul 29, 2015

First I do know there are flight paramedics, In fact the flight crew at the hospital I mentioned must be a RN and Paramedic. Also some of the area programs in my area fly with one RN and one medic. You are right I don't know all the protocols all over the US and I feel pretty confident in saying you don't either. And yes I don't work as a crew member but I would like to in the future and have done a lot of research on that program and I have talked to a few of the crew members. I ask you yet again have YOU ever been part of a flight crew?

I'm not making blanket statements, I understand over use is a problem all over the US but in my area I don't think it is. The program I speak of has been around for 30 plus years and the safety of the crew and patients its the number one priority. They don't make transport decisions lightly.

I still stand by my statement if the patient is 20 minutes away under the right circumstances using air transportation is appropriate.

Again I don't know what kind of EMS people you are around but I have never known someone to call the flight team just because they are too lazy to drive. That is a blanket statement. How many different areas have you worked, how many different EMS companies do you know people from. Can you speak for every EMS worker in the country. I'm pretty sure that's a no and I'm pretty sure you only have experience in a small area. Maybe that's what EMS does in your area but I assure your area is one of the few and possible only that do that. Paramedics and EMT's live for that critical patient, they are going to want to transport that patient and see the care as far as they can. They aren't going to say I don't feel like driving lets call med flight.

You are right I'm defending Flight nurses/paramedics AND EMS workers, but this isn't an ideal world this is reality and yes it has its flaws but so does everything else. I'm not hiding my head in the sand but you can NOT say every flight program in the entire US has overuse issues, you are NOT an expert on EVERY program in the entire US and I don't even think I would call you and expert in the subject at all. I don't believe I ever said overuse wasn't an issue in some programs.